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关节镜辅助下同种异体骨移植复位内固定治疗闭合性胫骨平台骨折

Arthroscopic-Assisted Reduction and Internal Fixation With Bone Allograft in Closed Tibial Plateau Fracture.

作者信息

Limskul Danaithep, Yoosuksomboon Nawit, Thamrongskulsiri Napatpong, Itthipanichpong Thun, Tanpowpong Thanathep, Kuptniratsaikul Somsak

机构信息

Division of Academic Affairs and Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand.

Sports Medicine Research Group, Faculty of Medicine, Chulalongkorn University, Pathumwan, Bangkok, Thailand.

出版信息

Arthrosc Tech. 2025 May 24;14(7):103635. doi: 10.1016/j.eats.2025.103635. eCollection 2025 Jul.

Abstract

Tibial plateau fractures, though rare, are critical due to their impact on weightbearing and joint function. The gold standard for surgical treatment is open reduction and internal fixation (ORIF), aiming to restore the tibial plateau's anatomy and address any concurrent injuries. However, ORIF involves extensive soft tissue dissection, posing risks such as infections, neurovascular injury, and long-term joint stiffness. This Technical Note presents an arthroscopic-assisted approach for the reduction and internal fixation of a Schatzker II tibial plateau fracture. The procedure involved minimal incisions, direct arthroscopic visualization, and the use of bone allograft to support the elevated plateau. This method offers several advantages over traditional ORIF, including reduced soft tissue dissection, decreased risk of complications, and improved precision in anatomic reduction. The technique also facilitates the diagnosis and treatment of associated intra-articular injuries, potentially leading to better functional outcomes and faster recovery.

摘要

胫骨平台骨折虽然罕见,但因其对负重和关节功能的影响而至关重要。手术治疗的金标准是切开复位内固定(ORIF),旨在恢复胫骨平台的解剖结构并处理任何并发损伤。然而,切开复位内固定需要广泛的软组织剥离,存在感染、神经血管损伤和长期关节僵硬等风险。本技术说明介绍了一种关节镜辅助下Schatzker II型胫骨平台骨折复位和内固定的方法。该手术切口最小,通过关节镜直接观察,并使用同种异体骨移植来支撑抬高的平台。与传统的切开复位内固定相比,这种方法具有几个优点,包括减少软组织剥离、降低并发症风险以及提高解剖复位的精度。该技术还便于诊断和治疗相关的关节内损伤,可能带来更好的功能结果和更快的恢复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d109/12351054/cf9205b7326b/gr1.jpg

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